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Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures Cover

Horizontal and Vertical Integration of Health Care Providers: A Framework for Understanding Various Provider Organizational Structures

Open Access
|Jan 2020

References

  1. Squires, D, Anderson, C. U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries. New York: The Commonwealth Fund; 2015. [Cited 2018 Nov 26]. Available from: https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2015_oct_1819_squires_us_hlt_care_global_perspective_oecd_intl_brief_v3.pdf. DOI: 10.15868/socialsector.25051
  2. Kodner, DL, Spreeuwenberg, C. Integrated care: Meaning, logic, applications, and implications—a discussion paper. International journal of integrated care, 2002; 2: e12. DOI: 10.5334/ijic.67
  3. Laugesen, MJ, France, G. Integration: the firm and the health care sector. Health Econ Policy Law, 2014 Jul; 9(3): 295312. DOI: 10.1017/S1744133114000139
  4. Evans, JM, Baker, GR, Berta, WB, Barnsley, J. The Evolution of Integrated Health Care Strategies. In: Goes, J, Savage, GT, Friedman, L (eds.), Annual Review of Healthcare Management: Revisiting the Evolution of Health Care Systems. Advances in Health Care Management. West Yorkshire: Emerald Group Publishing, 2013; 15: 12561. DOI: 10.1108/S1474-8231(2013)0000015011
  5. Cutler, D, Morton, FS. Hospitals, Market Share, and Consolidation. Journal of American Medical Association, 2013 Nov; 310(18): 19641970. DOI: 10.1001/jama.2013.281675
  6. Nikpay, SS, Richards, MR, Penson, D. Hospital-Physician Consolidation Accelerated in the Past Decade in Cardiology, Oncology. Health Affairs, 2018 Jul; 37(7): 11231127. DOI: 10.1377/hlthaff.2017.1520
  7. Abrams, M, Nuzum, R, Zezza, M, Ryan, J, Kiszla, J, Guterman, S. The Affordable Care Act’s Payment and Delivery System Reforms: A Progress Report at Five Years. New York: The Commonwealth Fund: 2015 May. [Cited 2018 Nov 26]. Available from: https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_issue_brief_2015_may_1816_abrams_aca_reforms_delivery_payment_rb.pdf. DOI: 10.15868/socialsector.25091
  8. Burwell, SM. Setting Value-Based Payment Goals—HHS Efforts to Improve U.S. Health Care. New England Journal of Medicine, 2015; 372: 897899. DOI: 10.1056/NEJMp1500445
  9. Casalino, LP. Categorizing Accountable Care Organizations: Moving Toward Patient-Centered Outcomes Research That Compares Health Care Delivery Systems. Health Serv Res, 2014 Dec; 49(6): 18751882. DOI: 10.1111/1475-6773.12254
  10. U.S. Agency for Healthcare Research and Quality. Comparative Health System Performance Initiative. AHRQ Pub. No. 16(17)-0040-EF. 2016 Oct. [web page on internet.] [cited 2019 Oct 10]. Available from: https://www.ahrq.gov/sites/default/files/wysiwyg/chsp/chsp-fact-sheet-0717.pdf.
  11. Green, BN, Johnson, CD, Adams, A. Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. Journal of Chiropractic Medicine, 2006; 5(3): 10117. DOI: 10.1016/S0899-3467(07)60142-6
  12. Burns, LR, Goldsmith, JC, Sen, A. Horizontal and Vertical Integration of Physicians: A Tale of Two Tails. In: Goes, J, Savage, GT, Friedman, L (eds.), Annual Review of Healthcare Management: Revisiting the Evolution of Health Systems Organizations. Advances in Health Care Management. West Yorkshire: Emerald Group Publishing, 2013; 15: 39117. DOI: 10.1108/S1474-8231(2013)0000015009
  13. McCarthy, D. Integrated Healthcare Delivery Models in an Era of Reform. In: Shiver, JM and Cantiello, J (eds.), Managing Integrated Health Systems. Burlington, MA: Jones and Bartlett; 2015. 124.
  14. Casalino, LP, Wu, FM, Ryan, AM, Copeland, K, Rittenhouse, DR, Ramsay, PP, Shortell, SM. Independent practice associations and physician-hospital organizations can improve care management for smaller practices. Health Aff (Milwood), 2013; 32(8): 13761382. DOI: 10.1377/hlthaff.2013.0205
  15. Shortell, SM, Casalino, LP, Fisher, ES. Achieving the Vision—Structural Change. In: Crosson, FJ, Tollen, LA (eds.), Partners in Health: How Physicians and Hospitals Can Be Accountable Together. San Francisco: Jossey-Bass; 2010. 4671.
  16. Page, S. ‘Virtual’ Health Care Organizations and the Challenges of Improving Quality. Health Care Manage Rev, 2003 Jan–Mar; 28(1): 7992. DOI: 10.1097/00004010-200301000-00009
  17. Casalino, LP, Chenven, N. Independent practice associations: Advantages and disadvantages of an alternative form of physician practice organization. Healthcare, 2017; 5: 4652. DOI: 10.1016/j.hjdsi.2016.08.003
  18. Shortell, SM, Casalino, LP, Fisher, ES. How the Center for Medicare and Medicaid Innovation Should Test Accountable Care Organizations. Health Aff (Milwood), 2010 Jul; 29(7): 12931298. DOI: 10.1377/hlthaff.2010.0453
  19. Fisher, ES, Staiger, DO, Bynum, JPW, Gottlieb, DJ. Creating Accountable Care Organizations: The Extended Hospital Medical Staff. Health Aff (Milbank), 2007; 26(1): w44w57. DOI: 10.1377/hlthaff.26.1.w44
  20. Shih, A, Davis, K, Schoenbaum, S, Gauthier, A, Nuzum, R, McCarthy, D. Organizing the U.S. Health Care Delivery System for High Performance. New York: The Commonwealth Fund; 2008 Aug. Publication No. 1155. Available from: https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2008_aug_organizing_the_u_s__health_care_delivery_system_for_high_performance_shih_organizingushltcaredeliverysys_1155_pdf.pdf.
  21. Lloyd, J, Houston, R, McGinnis, T. Medicaid Accountable Care Organization Programs: State Profiles. Hamilton, NJ: Center for Health Care Strategies, Inc; 2015 Oct. [cited 2017 May 22]. Available from: https://www.chcs.org/media/Medicaid-Accountable-Care-Organization-Programs-State-Profiles-1115.pdf.
  22. Fottler, M, Savage, GT, Blair, JD. The future of integrated delivery systems: a consumer perspective. In: Wolper, LF (ed.), Health Care Administration: Managing Organized Delivery Systems. 5th ed. Sudbury, MA: Jones and Bartlett Publishers; 2000. 67106.
  23. Enthoven, A. Curing Fragmentation with Integrated Delivery Systems: What They Do, What Has Blocked Them, Why We Need Them, and How to Get There From Here. In: Elhauge, E (ed.), The Fragmentation of U.S. Health Care. New York: Oxford University Press; 2010. 6185. DOI: 10.1093/acprof:oso/9780195390131.003.004
  24. Burns, LR, Pauly, MV. Integrated Delivery Networks: A Detour on the Road to Integrated Health Care? Health Aff (Milwood), 2002 Jul; 21(4): 128143. DOI: 10.1377/hlthaff.21.4.128
  25. Shortell, SM, Addicott, R, Walsh, N, Ham, C. Accountable care organisations in the United States and England: Testing, evaluating and learning what works. London: The King’s Fund, 2014. [Cited 2018 Nov 26]. Available from: https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/accountable-care-organisations-united-states-england-shortell-mar14.pdf.
  26. Wise, CG, Alexander, JA, Green, LA, Cohen, GR. Physician Organization-Practice Team Integration for the Advancement of Patient-Centered Care. J Ambul Care Manage, 2012 Oct–Dec; 35(4): 31122. DOI: 10.1097/JAC.0b013e3182606e7c
  27. American Hospital Association. 2016 AHA Annual Survey. Chicago, IL: American Hospital Association, 2016. [Cited 2017 May 22]. Available from: http://www.ahasurvey.org/taker/hardcopy_survey.pdf.
  28. Cuellar, AE, Gertler, PJ. Strategic Integration of Hospitals and Physicians. J Health Econ, 2006 Jan; 25(1): 128. DOI: 10.1016/j.jhealeco.2005.04.009
  29. Casalino, LP. The Federal Trade Commission, Clinical Integration, and the Organization of Physician Practice. J Health Polit Policy Law, 2006 Jun; 31(3): 56985. DOI: 10.1215/03616878-2005-007
  30. U.S. Department of Justice and the Federal Trade Commission. Statements of Antitrust Enforcement Policy in Health Care. Washington, DC: U.S. Department of Justice and the Federal Trade Commission; 1996 Aug.
  31. Burns, LR, Muller, RW. Hospital-Physician Collaboration: Landscape of Economic Integration and Impact on Clinical Integration. Milbank Q, 2008 Sep; 86(3): 375434. DOI: 10.1111/j.1468-0009.2008.00527.x
  32. Carluzzo, KL, Larson, BK, Van Citters, AD, et al. Monarch HealthCare: Leveraging Experience in Population Health Management to Attain Accountable Care. New York: The Commonwealth Fund; 2012 Jan. Publication No. 1573. [Cited 2018 Nov 26]. Available from: https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_case_study_2012_jan_1573_carluzzo_monarch_case_study_01_17_2012.pdf.
  33. American Medical Association. Corporate practice of medicine. Chicago, IL: American Medical Association; 2015. [2017 May 22]. Available from: https://www.ama-assn.org/sites/default/files/media-browser/premium/arc/corporate-practice-of-medicine-issue-brief_1.pdf.
  34. Essential Hospitals Institute. Integrated Health Care: Literature Review. Washington, DC: Essential Hospitals Institute; May 2013. [Cited 2018 Nov 26]. Available from: http://essentialhospitals.org/wp-content/uploads/2013/12/Integrated-Health-Care-Literature-Review-Webpost-8-22-13-CB.pdf.
  35. Enthoven, AC. Integrated Delivery Systems: The Cure for Fragmentation. Am J Manag Care, 2009 Dec; 15(10 Suppl): S284S290.
  36. Shortell, SM, McCurdy, RK. Integrated Health Systems. Information Knowledge Systems Management, 2009; 8: 369382. DOI: 10.3233/IKS-2009-0147
  37. Casalino, LP. Categorizing Accountable Care Organizations: Moving Toward Patient-Centered Outcomes Research That Compares Health Care Delivery Systems. Health Serv Res, 2014 Dec; 49(6): 18751882. DOI: 10.1111/1475-6773.12254
  38. Gillies, RR, Shortell, SM, Anderson, DA, Mitchell, JB, Morgan, KL. Conceptualizing and Measuring Integration: Findings from the Health Systems Integration Study. Hosp Health Serv Adm, 1993 Winter; 38(4): 46789.
  39. Goldsmith, J, Burns, LR, Sen, A, Oldsmith, T. Integrated Delivery Networks: In Search of Benefits and Market Effects. Washington, DC: National Academy of Social Insurance, 2015. [Cited 2018 Nov 26]. Available from: https://www.nasi.org/sites/default/files/research/Integrated_Delivery_Networks_In_Search_of_Benefits_and_Market_Effects.pdf.
  40. Burns, LR, Pauly, MV. Accountable Care Organizations May have Difficulty Avoiding the Failures of Integrated Delivery Networks of the 1990s. Health Aff (Milwood), 2012 Nov; 31(11): 24072416. DOI: 10.1377/hlthaff.2011.0675
  41. Machta, RM, Maurer, KA, Jones, DJ, Furukawa, MF, Rich, EC. A Systematic Review of Vertical Integration and Quality of Care, Efficiency, and Patient-Centered Outcomes. Health Care Management Review, 2018 Apr; 45(1).
  42. Burns, LR, Walston, S, Alexander, JA, Zuckerman, HS, Andersen, RM, Torrens, P. Just how integrated are integrated delivery systems? Results from a national survey. Health Care Management Review, 2001; 26(1): 2241. DOI: 10.1097/00004010-200101000-00003
  43. Hwang, W, Chang, J, LaClair, M, Paz, H. Effects of Integrated Delivery System on Cost and Quality. Amer J Manag Care, 2013 May; 19(5): e175e184.
  44. Muhlestein, D, Saunders, R, McClellan, M. Growth of ACOs and Alternative Payment Models in 2017. Health Affairs Blog, June 28, 2017. [Cited 2018 Nov 26]. Available from: https://www.healthaffairs.org/do/10.1377/hblog20170628.060719/full/.
  45. Kreindler, SA, Larson, BK, Wu, FM, et al. Interpretations of Integration in Early Accountable Care Organizations. Milbank Q, 2012; 90(3): 457483. DOI: 10.1111/j.1468-0009.2012.00671.x
  46. Kaufman, BG, Spivack, BS, Stearns, SC, Song, PH, O’Brien, EC. Impact of Accountable Care Organizations on Utilization, Care, and Outcomes: A Systematic Review. Medical Care Research and Review, 2017: 136.
  47. McWilliams, JM, Hatfield, LA, Landon, BE, Hamed, P, Chernew, ME. Medicare Spending after 3 Years of the Medicare Shared Savings Program. NEJM, 2018; 379: 11391149. DOI: 10.1056/NEJMsa1803388
  48. Lewis, VA, Fisher, ES, Colla, CH. Explaining Sluggish Savings Under Accountable Care. New England Journal of Medicine, 2017 Nov; 377: 18091811. DOI: 10.1056/NEJMp1709197
  49. Kerrissey, MJ, Clark, JR, Friedberg, MW, et al. Medical Group Structural Integration May Not Ensure That Care Is Integrated, From the Patient’s Perspective. Health Aff (Milwood), 2017 May; 36(5): 885892. DOI: 10.1377/hlthaff.2016.0909
DOI: https://doi.org/10.5334/ijic.4635 | Journal eISSN: 1568-4156
Language: English
Submitted on: Nov 27, 2018
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Accepted on: Dec 11, 2019
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Published on: Jan 20, 2020
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2020 Jessica Heeringa, Anne Mutti, Michael F. Furukawa, Amanda Lechner, Kristin A. Maurer, Eugene Rich, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.